Interchangeable tools for surgical instruments

ABSTRACT

A surgical tool for use with a surgical instrument including a handle assembly and an elongated body defining a longitudinal axis and a drive system is disclosed. The surgical tool comprises a carrier removably couplable to the elongated body, an anvil movably supported for selective movement relative to the carrier in response to drive motions from the drive system, a tissue thickness measuring member movably supported in the carrier and configured to move toward and away from an underside of the anvil in a direction that is transverse to the longitudinal axis, and a sensor arrangement supported between the tissue thickness measuring member and the carrier. The sensor arrangement is configured to interface with an indicator member to provide an indication of a thickness of tissue clamped between the anvil and the tissue thickness measuring member at a location that is proximal to the anvil when in use.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 14/272,197, filedMay 7, 2014, entitled INTERCHANGEABLE TOOLS FOR SURGICAL INSTRUMENTS,now U.S. Patent Application Publication No. 2014/0243865, which is acontinuation application claiming priority under 35 U.S.C. § 120 to U.S.patent application Ser. No. 12/031,611, filed Feb. 14, 2008, entitledINTERCHANGEABLE TOOLS FOR SURGICAL INSTRUMENTS, which issued on Jun. 24,2014 as U.S. Pat. No. 8,758,391, the entire disclosures of which arehereby incorporated by reference herein.

FIELD OF THE INVENTION

The present invention relates in general to surgical instrumentsincluding, but not limited to, surgical instruments normally used withdisposable cutting and stapling units that are capable of applying linesof staples to tissue while cutting the tissue between those staple linesand, more particularly, to a collection of interchangeable tools for usewith such instruments.

COMMONLY-OWNED PATENT APPLICATIONS

The Assignee of the subject application also co-owns the following U.S.Patent Applications which are herein incorporated by reference:

U.S. patent application Ser. No. 11/729,008, entitled LAPAROSCOPICTISSUE THICKNESS AND CLAMP LOAD MEASURING DEVICES, filed Mar. 28, 2007,now U.S. Pat. No. 8,893,946;

U.S. patent application Ser. No. 11/652,170, entitled SURGICAL STAPLERWITH TAPERED DISTAL END, filed Jan. 11, 2007, now U.S. PatentApplication Publication No. 2008/0169333;

U.S. patent application Ser. No. 12/031,628, entitled DISPOSABLE MOTORDRIVEN LOADING UNIT FOR USE WITH A SURGICAL CUTTING AND STAPLINGAPPARATUS; filed Feb. 14, 2008, now U.S. Pat. No. 7,793,812; and U.S.patent application Ser. No. 12/031,001, entitled ARTICULATABLE LOADINGUNITS FOR SURGICAL STAPLING AND CUTTING INSTRUMENTS, filed Feb. 14,2008, now U.S. Patent Application Publication No. 2009/0206133.

BACKGROUND

Endoscopic surgeries are often preferred over traditional open surgicalprocedures because the smaller incision required by endoscopic surgicalprocedures tends to reduce the post-operative recovery time andcomplications. A variety of surgical procedures are currently performedby laparoscopic or other endoscopic techniques. Such procedures mayinclude, for example, intestinal and stomach operations such as removalof colon cancer, hernia repairs, stomach stapling, removal of gallbladder, Ob/Gyn related surgeries as well as other procedures, such asthose involving manipulations of a patient's spleen, liver, lung, heart,etc.

Consequently, significant development has gone into a range ofendoscopic surgical instruments that are suitable for precise placementof a distal end effector at a desired surgical site through a cannula ofa trocar that has been inserted into a patient. These distal endeffectors engage or interact with the tissue in a number of ways toachieve a desired diagnostic or therapeutic effect. Such devices areoften configured to perform a single type of surgical action (e.g.,endocutter, grasper, cutter, staplers, clip applier, access device,drug/gene therapy delivery device, and energy device using ultrasound,RF, laser, etc.) which often requires the clinician to use severaldifferent instruments that are each only adapted to perform one actionduring a single operation. For example, U.S. Pat. Nos. 5,352,235;5,383,895; and 5,728,121 each disclose dedicated grasping instrumentsthat may be used for endoscopic and laparoscopic procedures. For thoseprocedures requiring the removal of tissue or specimens from the body(e.g., removal of a diseased gall bladder, appendix, etc.), dedicatedspecimen retrieval instruments such as those disclosed in U.S. Pat. No.6,406,440 have been developed. For procedures requiring the cutting andsevering of tissue, dedicated scissor instruments such as thosedescribed in U.S. Pat. No. 6,168,605 have also been developed.

For those procedures involving the cutting and stapling of tissue,various surgical stapling devices have been designed. Such surgicalstapling devices commonly include an end effector that simultaneouslymakes a longitudinal incision in tissue and applies lines of staples onopposing sides of the incision. The end effector includes a pair ofcooperating jaw members that, if the instrument is intended forendoscopic or laparoscopic applications, are capable of passing througha cannula passageway. One form of surgical cutting and stapling deviceis disclosed in U.S. Pat. No. 6,905,057. Such devices have a dedicatedreusable drive and knife beam and are designed to be used withreplaceable staple cartridges. Removable cartridges constructed tomeasure tissue thickness such as those disclosed in U.S. patentapplication Ser. No. 11/729,008, entitled LAPAROSCOPIC TISSUE THICKNESSAND CLAMP LOAD MEASURING DEVICES, now U.S. Pat. No. 8,893,946, have alsobeen designed for use with such instruments. Alternative curved endeffector arrangements such as those disclosed in U.S. patent applicationSer. No. 11/652,170, entitled SURGICAL STAPLER WITH TAPERED DISTAL END,now U.S. Patent Application Publication 2008/0169333, also havededicated reusable knife and drive beam arrangements for use withremovable/replaceable staple cartridges.

Other types of surgical stapling devices such as those disclosed in U.S.Pat. No. 5,865,361 are configured to operate with disposable loadingunits (DLU's) that are constructed to support a dedicated staplecartridge and knife assembly therein. Once the procedure is completed,the entire DLU is discarded. Such instruments that are designed toaccommodate DLU's purport to offer the advantage of a “fresh” knifeblade for each firing of the instrument. The reusable hand piece portionof such surgical stapling instruments was limited to use in connectionwith disposable loading units that were constructed to cut and stapletissue. Thus, for operations that involve various actions and procedures(e.g., grasping and manipulating tissue, cutting tissue, removal oftissue, applying clips and/or staples, cauterization of tissue, deliveryof drugs and medicaments, etc.) a collection of different surgicalinstruments that are designed specifically to perform one of thoseactions in the past were required to be on hand.

Thus, there is a need for different types of interchangeable surgicaltool attachments that may be used with a single surgical instrument handpiece.

SUMMARY

In one general aspect of various embodiments of the present invention,there is provided a surgical tool for use with a surgical instrumentthat has a handle assembly that operably supports a drive system thereinfor generating drive motions upon actuation of a movable handle portionthereof. The surgical instrument further has an elongated body thatoperably supports a control rod therein for transferring the drivemotions. Various embodiments of the surgical tool comprise a housingthat is removably couplable to the elongated body. A drive assembly maybe operably supported in the housing and is removably couplable to thecontrol rod. A pair of non-staple forming jaws are operably coupled tothe drive assembly such that upon application of a drive motion to thedrive assembly in a first direction the non-staple forming jaws eachsimultaneously move in a closing direction toward each other and uponapplication of another drive motion in a second direction, thenon-staple forming jaws each simultaneously move in an opening directionaway from each other.

In still another general aspect of various embodiments of the presentinvention, there is provided a surgical tool for use with a surgicalinstrument that has a handle assembly that operably supports a drivesystem therein for generating drive motions upon actuation of a movablehandle portion thereof. The surgical instrument may further have anelongated body that operably supports a control rod therein fortransferring the drive motions. Various embodiments of the surgical toolmay comprise a carrier that has a housing coupled thereto. The housingmay be movably couplable to the elongated body. A drive assembly may beoperably supported in the housing and carrier and be removably couplableto the control rod. A non-staple forming anvil may be movably supportedon the carrier and configured to operably interact with the driveassembly to selectively move the non-staple forming anvil toward andaway from the carrier. A tissue thickness measuring cartridge may besupported in the carrier. The tissue thickness measuring cartridge mayhave an indicator member that interacts with the housing to provide anindication of a thickness range of tissue clamped between the non-stapleforming anvil and the tissue thickness measuring cartridge.

In another general aspect of various embodiments of the presentinvention, there is provided a surgical tool for use with a surgicalinstrument that has a handle assembly that operably supports a drivesystem therein for generating drive motions upon actuation of a movablehandle portion thereof. The surgical instrument may further have anelongated body that operably supports a control rod therein fortransferring the drive motions. In various embodiments, the surgicaltool comprises a housing that is directly couplable to the elongatedbody. A drive assembly may be operably supported in the housing andcarrier. The drive assembly may be removably couplable to the controlrod. A staple-forming anvil may be non-movably supported by the housing.A plurality of staples may be supported in a distal end of the housingand be oriented to be sequentially driven into the staple-forming anvilupon application of a drive motion to the drive assembly.

In another general aspect of various embodiments of the presentinvention, there is provided a surgical tool for use with a surgicalinstrument that has a handle assembly that operably supports a drivesystem therein for generating drive motions upon actuation of a movablehandle portion thereof. The surgical instrument may further have anelongated body that operably supports a control rod therein fortransferring the drive motions. In various embodiments, the surgicaltool comprises a housing that is directly couplable to the elongatedbody. A pair of opposed, moveable jaws may be attached to and extendfrom the shaft. The jaws are configured to receive each of the surgicalclips serially therein when the jaws are in an open position. The jawsmay also form each of the surgical clips received serially therein whenthe jaws are moved to a closed position. A moveable forming mechanismmay be removably couplable to the control rod when the housing iscoupled to the elongated body. The forming mechanism may be configuredto move the jaws from the open position to the closed position uponapplication of a first drive motion from the control rod so as to formeach of the surgical clips received serially therein. The formingmechanism may be further configured to move from the closed position tothe open position upon application of a second drive motion to theforming mechanism by the control rod. A feeding mechanism mayoperatively interact with the movable forming mechanism. The feedingmechanism may have a feed plate that is movable in response to movementof the forming mechanism and may be releasably coupled to a clip pusherof the feed mechanism. The clip pusher may be stationary and uncoupledfrom the feed plate upon application of the first drive motion to theforming mechanism. The clip pusher may be moveable and operativelycoupled to the feed plate upon application of the second drive motion tothe movable forming mechanism so as to move each of the surgical clipsserially from the shaft into the jaws.

In connection with another general aspect of the present invention thereis provided a surgical tool for use with a surgical instrument that hasa handle assembly that operably supports a drive system therein forgenerating drive motions upon actuation of a movable handle portionthereof. The surgical instrument may further have an elongated body thatoperably supports a control rod therein for transferring the drivemotions. Various embodiments of the surgical tool of the presentinvention may comprise a carrier that has a housing coupled thereto. Thehousing may be removably couplable to the elongated body. A driveassembly may be operably supported in the housing and carrier and alsobe removably couplable to the control rod. A staple forming anvil may bemovably supported on the carrier and operably interact with the driveassembly to selectively move the staple forming anvil toward and awayfrom the carrier. A staple-supporting cartridge that has a radius ofcurvature may be supported in the carrier. The staple-supportingcartridge may have a curved slot therethrough defining a curved passagefor receiving a distal end of the drive assembly therethrough uponapplication of a drive motion thereto.

In accordance with another general aspect of the present invention thereis provided a surgical tool for use with a surgical instrument that hasa handle assembly that operably supports a drive system therein forgenerating drive motions upon actuation of a movable handle portionthereof. An elongated body may operably support a control rod thereinfor transferring the drive motions. Various embodiments of the surgicaltools may comprise a housing that is removably couplable to theelongated body. A syringe body may be coupled to the housing. A hollowneedle may protrude from the syringe body. A drive assembly may beoperably supported in the housing and may be removably couplable to thecontrol rod. A syringe plunger may be movably supported in the syringebody and may be coupled to the drive assembly for selective movementtherewith.

In accordance with still another general aspect of the present inventionthere is provided a surgical tool for use with a surgical instrumentthat has a handle assembly that operably supports a drive system thereinfor generating drive motions upon actuation of a movable handle portionthereof. An elongated body may operably support a control rod thereinfor transferring the drive motions. Various embodiments of the surgicaltool may comprise a housing that is removably couplable to the elongatedbody. A non-staple applying end effector may operably protrude from adistal end of the housing. The non-staple applying end effector maysupport at least one electrically powered member. A battery may bemovably supported within the housing and be configured to electricallycommunicate with the at least one electrically powered member. Thebattery may be removably couplable to the control rod such that uponapplication of a first drive motion thereto, the battery applies powerto the electrical powered member and, upon application of a second drivemotion thereto, the battery discontinues the application of power to theelectrically powered member.

In accordance with another general aspect of the present invention thereis provided a surgical tool system that includes a surgical instrumentthat may comprise a handle assembly that has a drive system operablysupported therein for generating drive motions upon actuation of amovable handle portion that is operably coupled to the handle assembly.An elongated body may protrude from the handle assembly and a controlrod may be operably supported in the elongated body. The control rod mayinterface with the drive system for receiving the drive motionstherefrom. The system may further include at least two surgical toolsthat are selected from the group of surgical tools consisting of:manipulators, nippers, scissors, endocutters, tissue thicknessmeasurement devices, staple appliers, clip appliers, syringeglue/sealant/drug/medicament appliers and cauterization devices whereineach surgical tool within the group of surgical tools at least has ahousing that is removably couplable to the elongated body and a driveassembly that is removably couplable to the control rod for receivingthe drive motions therefrom.

These and other objects and advantages of the present invention shall bemade apparent from the accompanying drawings and the descriptionthereof.

BRIEF DESCRIPTION OF THE FIGURES

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of various embodiments of theinvention given above, and the detailed description of the embodimentsgiven below, serve to explain various principles of the presentinvention.

FIG. 1 is a perspective view of a prior surgical cutting and staplingapparatus.

FIG. 2 is a side view of a surgical tool embodiment of the presentinvention.

FIG. 3 is a cross-sectional view of the surgical tool embodiment of FIG.2 with some components thereof shown in full view for clarity.

FIG. 4 is another cross-sectional view of the surgical tool embodimentof FIGS. 2 and 3 in a closed position.

FIG. 5 is a perspective view showing one exemplary use of the surgicaltool embodiment of FIGS. 2-4 in connection with another surgical toolembodiment of the present invention for removing tissue from a patient.

FIG. 6 is a cross-sectional view of another surgical tool embodiment ofthe present invention with some components thereof shown in full viewfor clarity.

FIG. 7 is a perspective view of another surgical tool embodiment of thepresent invention.

FIG. 8 is a perspective view of another surgical tool embodiment of thepresent invention.

FIG. 9 is a cross-sectional view of the surgical tool embodiment of FIG.8.

FIG. 10 is an enlarged cross-sectional view of the distal end of thesurgical tool of FIGS. 8 and 9 in a pre-fired position.

FIG. 11 is another enlarged cross-sectional view of the distal end ofthe surgical tool of FIGS. 8-10 wherein a staple is being fired intotissue.

FIG. 12 is another enlarged cross-sectional view of the distal end ofthe surgical tool of FIGS. 8-11 after a first staple has been fired.

FIG. 13 is a perspective view of another surgical tool embodiment of thepresent invention.

FIG. 14 is a cross-sectional view of the surgical tool embodiment ofFIG. 13 with some components thereof shown in full view for clarity.

FIG. 15 is a perspective view of another surgical tool embodiment of thepresent invention.

FIG. 16 is an exploded assembly view of a portion of the surgical toolembodiment of FIG. 15.

FIG. 17 is a side elevational view of the surgical tool embodiment ofFIGS. 15 and 16 with the anvil assembly in an open position.

FIG. 18 is another side elevational view of the surgical tool embodimentof FIGS. 15 and 16 with a portion thereof shown in cross-section andwith the anvil assembly shown in a first closed position with no tissueclamped therein.

FIG. 19 is an enlarged view of the distal end of the surgical toolembodiment depicted in FIG. 18.

FIG. 20 is a cross-sectional view of the surgical tool of FIG. 18 takenalong line 20-20 in FIG. 18.

FIG. 21 is an enlarged view of the distal end portion of the surgicaltool shown in FIG. 20.

FIG. 22 is an exploded assembly view of a thickness measurementcartridge portion of the surgical tool of FIGS. 15-21.

FIG. 23 is another exploded assembly view of portions of the thicknessmeasurement cartridge of FIG. 21.

FIG. 24 is a cross-sectional view of a portion of the surgical tool ofFIG. 17 taken along line 24-24 in FIG. 17.

FIG. 25 is a cross-sectional view of a portion of the surgical tool ofFIG. 17 taken along line 25-25 in FIG. 17.

FIG. 26 is a side elevational view of the surgical tool embodiment ofFIGS. 15-25 with anvil assembly in a closed position for clamping tissuehaving a first thickness range therein.

FIG. 27 is an enlarged view of the distal end of the surgical toolembodiment depicted in FIG. 26.

FIG. 28 is a side elevational view of the surgical tool embodiment ofFIGS. 15-27 with the anvil assembly in a closed position for clampingtissue having a second thickness range therein.

FIG. 29 is a side elevational view of the surgical tool embodiment ofFIGS. 15-28 with the anvil assembly in a closed position for clampingtissue having a third thickness range therein.

FIG. 30 is a side elevational view of the surgical tool embodiment ofFIGS. 15-29 with the anvil assembly in a closed position for clampingtissue having a fourth thickness range therein.

FIG. 31 is a perspective view of a portion of another surgical toolembodiment of the present invention with the cover removed therefrom.

FIG. 32 is a perspective view of portions of a forming plate and feedplate arrangement of the surgical tool of FIG. 31.

FIG. 33 is a plan view of the surgical tool embodiment of FIG. 31 withthe cover removed for clarity.

FIG. 34 is a cross-sectional view of the surgical tool of FIGS. 31-33.

FIG. 35 is a cross-sectional view of the surgical tool of FIG. 34 takenalong lines 35-35 in FIG. 34.

FIG. 36 is a plan view of another surgical tool embodiment of thepresent invention with a portion of the anvil assembly omitted forclarity.

FIG. 37 is a plan view of another surgical tool embodiment of thepresent invention with a portion of the anvil assembly omitted forclarity.

FIG. 38 is a perspective view of another surgical tool embodiment of thepresent invention.

FIG. 39 is a cross-sectional view of a portion of the housing of thesurgical tool of FIG. 38.

FIG. 40 is an exploded assembly view of another surgical tool embodimentof the present invention used in connection with another surgicalinstrument embodiment of the present invention.

FIG. 41 is a perspective view of an alternate housing embodiment of thepresent invention with a portion thereof shown in phantom lines toillustrate the ability to articulate about an articulation member formedtherein.

FIG. 42 is a perspective view of another alternate housing embodiment ofthe present invention.

DETAILED DESCRIPTION

Turning to the Drawings, wherein like numerals denote like componentsthroughout the several views, FIG. 1 depicts a prior surgical instrument10 that includes a housing assembly 12 and an elongated body 14 thatprotrudes therefrom. Also shown in FIG. 1 is a prior disposable loadingunit 16 that comprises a single-use endocutter for cutting tissue andapplying lines of staples on each side of the cut. The disposableloading unit 16 includes a tool assembly 17 having a cartridge assembly18 housing a plurality of surgical staples and an anvil assembly 20movably secured in relation to cartridge assembly 18. In variousembodiments, the conventional surgical instrument 10 and the disposableloading unit 16 may comprise the surgical instrument and disposableloading units described in U.S. Pat. No. 5,865,361, entitled SURGICALSTAPLING APPARATUS, issued Feb. 2, 1999, the disclosure of which hasbeen herein incorporated by reference. Thus, the present DetailedDescription will not specifically discuss the various components of thesurgical instrument 10 and the disposable loading unit 16 and theiroperation herein beyond what is necessary to describe the operation ofthe various surgical tool embodiments of the present invention which maybe used with a surgical instrument 10.

As the present Detailed Description proceeds, it will be appreciatedthat the terms “proximal” and “distal” are used herein with reference toa clinician gripping a handle assembly 12 of the surgical instrument 10to which a particular surgical tool is operably coupled. Thus, thesurgical tool is “distal” with respect to the more proximal handleassembly 12. It will be further appreciated that, for convenience andclarity, spatial terms such as “vertical”, “horizontal”, “up”, “down”,“right”, and “left” are used herein with respect to the drawings.However, surgical tools and instruments are used in many orientationsand positions, and these terms are not intended to be limiting andabsolute.

FIGS. 2-4 depict a surgical tool 1000 of an embodiment of the presentinvention that may be operably coupled to the surgical instrument 10 andused to manipulate tissue, organs, etc. As can be seen in those Figures,the surgical tool 1000 may include a housing 1010 that has a proximalend 1012 that is configured for removable attachment to the elongatedbody 14 of the surgical instrument 10. In particular, the proximal end1012 may have engagement nubs 254 formed thereon which serve to form abayonet-type coupling with the distal end of the elongated body portion14 of the surgical stapling apparatus as described in U.S. Pat. No.5,865,361.

The surgical tool 1000 includes a drive assembly 1020 that may include aproximal drive beam segment 1022 that is coupled to a distal drive beamsegment 1030 by a reversing linkage assembly 1040. The drive beamsegments 1020, 1030 may each be constructed from a single sheet ofmaterial or, preferably, from multiple stacked sheets. However, drivebeam segments 1020, 1030 may be fabricated from other suitable materialsand arrangements. As can be seen in FIG. 3, the proximal drive beamsegment 1022 has an engagement section 1024 formed thereon that mayinclude a pair of engagement fingers 1024 a and 1024 b that aredimensioned and configured to mountingly engage a drive member 1026.Drive member 1026 includes a proximal porthole 1028 configured toreceive the distal end 276 of control rod 52 (See FIG. 1) when theproximal end 1012 of tool attachment 100 is coupled to the elongatedbody 14 of surgical apparatus 10. As can be seen in FIG. 3, the proximalend 1012 has a hollow passage 1014 therein through which the distal end276 of the control rod 52 may extend.

The distal end of the proximal beam segment 1022 has a distallyprotruding tab 1028 that is pinned to a link 1042 of the reversinglinkage assembly 1040. The link 1042 is pivotally attached to thehousing 1010 by pin 1044 and is also attached to a proximal tab portion1032 of distal drive beam segment 1030. The distal end 1034 of thedistal drive beam segment 1030 may be pivotally attached to an uppernon-staple forming manipulation jaw 1050 by a first pivot link 1052 andalso attached to a lower non-staple-forming manipulation jaw 1060 by asecond pivot link 1062. As used herein, the term “non-staple forming”refers to jaws that are designed to grip or manipulate tissue, but arenot designed to form, support or drive staples, such as, for example,anvils, staple cartridges or portions of units designed to supportstaple cartridges.

FIGS. 2 and 3 illustrate the upper and lower manipulation jaws 1050,1060 in an open orientation and FIG. 4 illustrates the upper and lowermanipulation jaws 1050, 1060 in a closed orientation. Once the surgicaltool 1000 is coupled to the elongated body 14 of the surgical apparatus10 (and the distal end 276 of the control rod 52 is coupled to the drivemember 2026), the clinician may move the upper and lower manipulationjaws 1050, 1060 between the open and closed positions by manipulatingthe movable handle portion 24 of the surgical apparatus 10. For example,pivoting the movable handle portion 24 toward the stationary portion 22of the handle assembly 12, causes the control rod 52 to move theproximal drive beam segment 1022 in a “first” distal direction “DD”. Asthe proximal drive beam segment 1022 moves in the first distal direction“DD”, the reversing linkage 1040 pulls the distal drive beam segment1030 in a “second” proximal direction “PD” which causes the links 1052,1062 to each simultaneously move the upper and lower non-staple formingmanipulation jaws 1050, 1060 toward each other to a closed orientation.Moving the movable handle 24 away from the stationary handle portion 22causes the non-staple forming upper and lower manipulation jaws 1050,1060 to each simultaneously move away from each other to the openposition.

The person of ordinary skill in the art will understand that thenon-staple forming upper and lower manipulation jaws 1050, 1060 may beprovided in different shapes and sizes without departing from the spiritand scope of the present invention. For example, FIG. 5 illustrates oneuse of the surgical tool 1000 of the present invention in connectionwith the removal of tissue, etc. from a body cavity 600. Morespecifically, FIG. 5 illustrates use of a conventional first trocar 610that is used to form a first passage 604 through a body wall 602 intothe body cavity 600. A surgical tool 1000 of the present invention isattached to a first convention surgical apparatus 10. The surgical tool1000 is then inserted through a cannula in the first trocar 610 and intothe body cavity 600 to grasp and manipulate a portion of tissue 606.

Some medical procedures may require portions of diseased tissue ororgans to be removed from the body cavity 600. To facilitate removal ofsmall amounts of such tissue from the body cavity 600, another surgicaltool 1100 of the present invention may be employed. As can be seen inFIG. 5, the surgical tool 1100 may include a housing portion 1110 thathas a proximal end 1112 that has nubs 254 formed thereon to facilitateattachment to the elongated body portion 14 of a surgical apparatus 10′in the manner described above. Housing 1110 may have a hollow cavitytherein, that would facilitate the movement of the control rod 52therein. However, in various embodiments, the distal end 276 of thecontrol rod is not directly coupled to any component within the housing.Attached to the distal end 1114 of the housing 1110 is aspecimen-retrieval pouch 1120 that may be formed from a collapsiblepouch ring portion 1122 that has a flexible pouch member 1124 attachedthereto. The collapsible pouch ring 1122 may be fabricated from springarms 1226 or the like that would enable the pouch ring portion 1122 tocollapse to enable the specimen retrieval pouch 1120 to be inserted intoand retracted from a cannula of a conventional trocar 610 or the like.

Returning to FIG. 5, there is also illustrated a surgical tool 1100 ofthe present invention that has been attached to another conventionalsurgical instrument 10′ that has been inserted through anotherconventional trocar 610. After the pouch assembly 1120 has been passedthrough the trocar cannula into the body cavity 600, the collapsiblepouch ring 1122 springs open. The surgical tool 1000 may be employed tograsp diseased tissue 606 (e.g., gall stones, etc.) and place thediseased tissue 606 into the pouch assembly 1120 which may then beretracted out through the cannula of the second conventional trocar 610.A draw string 1121 extends around the pouch ring 1112 and through thehousing 1110 to be threaded through a portion of the elongated body 14and may exit through a hole therein adjacent the handle assembly 12. Thedraw string 1121 may be used to close the specimen retrieval pouch 1120when removing the filled pouch 1120 from the body cavity.

Certain other medical procedures involve the cutting and removal ofsmall portions of tissue such as the removal of a polyp 700 or theextraction of a small portion of tissue for testing. A surgical toolembodiment 1200 of the present invention may be used to perform suchactivities. More specifically and with reference to FIG. 6, a surgicaltool 1200 may include the housing portion 1110 and drive beam segments1022, 1030 as was described above. The surgical tool 1200 is coupled tothe elongated body portion 14 and the control rod 52 in the mannerdescribed above and is operated by moving the movable handle portion 24toward and away from the stationary handle portion 22 as was alsodescribed above. However, in various embodiments, instead of havingupper and lower manipulation jaws coupled thereto, an upper tissuenipping jaw 1210 and a lower tissue nipping jaw 1220 are attached tolinks 1052 and 1062, respectively. As can be seen in FIG. 6, the upperand lower tissue nipping jaws 1210 and 1220 are designed to nip tissuegrasped therebetween. At least one of the jaws 1210, 1220 have a cavityportion 1211 therein for retrieving the nipped tissue. In the embodimentdepicted in FIG. 6, each tissue nipping jaw 1210, 1220 have a cavityportion 1211 formed therein that cooperate to form a hollow receptaclearea generally designated as 1230 when the jaws 1210, 1220 aresubstantially closed. Thus, after the tissue 700 has been nipped byclosing the jaws 1210, 1220, the tissue 700 is then received in thehollow receptacle area 1230 for removal from the body.

FIG. 7 illustrates another surgical tool 1300 of the present inventionthat includes the housing portion 1110 and drive assembly 1020 asdescribed above. As can be seen in FIG. 7, however, the surgical tool1300 employs scissor jaws 1310 and 1320. In particular, the upperscissor jaw 1310 is attached to link 1052 and the lower scissor jaw isattached to link 1062. A support member 1380 protrudes out of the distalend of the housing portion 1110 and pivotally supports the scissor jaws1310, 1320 about a pivot pin 1382 as shown. The surgical tool 1300 iscoupled to the elongated body portion 14 and the control rod 52 of thesurgical instrument 10 in the manner described above and is operated bymoving the movable handle portion 24 toward and away from the stationaryhandle portion 22 as was also described above. Thus, the scissor jaws1310, 1320 may be aligned with each other to enable the surgical tool1300 to be inserted through a cannula (trocar) into the body cavity andthen activated to cut tissue by moving the movable handle portion 24 ofthe surgical instrument 10.

FIGS. 8-12 illustrate another surgical tool 1400 that may be used withthe conventional surgical instrument 10. As can be seen in thoseFigures, the surgical tool 1400 comprises a stapler for stapling tissue.More particularly and with reference to FIG. 8, the surgical tool 1400may include a housing portion 1410 that has a proximal end portion 1412that is configured for removable attachment to the elongated body 14 ofthe surgical instrument 10. In particular, the proximal end portion 1412may have engagement nubs 254 formed thereon which serve to form abayonet-type coupling with the distal end of the elongated body portion14 of the surgical instrument 10 as described above. The surgical tool1400 may include a drive assembly 1420 that includes an elongated drivebeam 1422 that may be constructed from a single sheet of material or,preferably, from multiple stacked sheets. However, drive beam 1422 maybe fabricated from other suitable materials and arrangements. As can beseen in FIG. 9, the drive beam 1422 has an engagement section 1424formed thereon that may include a pair of engagement fingers 1424 a and1424 b that are dimensioned and configured to mountingly engage a drivemember 1426. Drive member 1426 includes a proximal porthole 1428configured to receive the distal end 276 of control rod 52 (See FIG. 1)when the proximal end 1412 of the surgical tool 1400 is coupled to theelongated body 14 of a surgical instrument 10. As can be seen in FIG. 9,the proximal end 1412 has a hollow passage 1414 therein through whichthe distal end 276 of the control rod 52 may extend.

As can also be seen in FIGS. 9-12, the housing 1410 has a distal endportion 1416 that operably houses columns 1430 of surgical staples 1432therein. In various embodiments, the housing 1410 may be fabricated inmultiple segments to permit installation of the staples 1432 therein.For single use embodiments, the staples 1432 may be installed at thefactory and the housing portions permanently assembled together byadhesive, snaps, etc. In other embodiments, the housing portions may beremovably coupled together to permit installation of additional staples1432. As can also been in FIGS. 9-12, a staple driver 1440 is affixed tothe distal end of the drive beam 1422. The distal end 1442 of the stapledriver 1440 may have a staple-receiving notch 1444 formed therein as canbe seen in FIGS. 10-12.

The surgical tool 1400 is coupled to the elongated body portion 14 andthe control rod 52 of the surgical instrument 10 in the manner describedabove and is operated by moving the movable handle portion 24 toward andaway from the stationary handle portion 22 as was also described above.A return spring 1450 is supported between a wall portion 1418 of thehousing 1410 and a return tab portion 1446 on the staple driver 1440 toassist with returning the staple driver 1440 to the return positionwherein another staple 1432 may drop into a firing position as shown inFIG. 10. As can be seen in FIG. 10, when in a firing position, thebottom staple 1432 in the distal-most column 1430 of staples 1432 hasdropped into engagement with the staple-receiving notch 1444 in thestaple driver 1440. A leaf-type feed spring 1470 may be provided to biaseach succeeding staple 1432 in the distal-most column 1430 of staplesdownward toward the staple driver 1440. In addition, a spring assembly1480 (illustrated in box-form in FIGS. 10-12) is mounted in the distalend portion 1416 of the housing 1410 to bias the columns 1430 of staples1432 in the distal direction “DD” on the staple driver 1440 so that asone column of staples 1432 is depleted, the next adjacent column ofstaples 1432 is biased into the firing position shown in FIG. 10.

Thus, to use the surgical tool 1400, the distal end 1416 of the housingportion 1410 is brought into engagement with the tissue “T” to bestapled. See FIG. 11. As can be seen in FIGS. 10-12, the distal endportion 1416 has an angled end 1417 that has an opening 1419 therein toexpose the staple 1432 being fired. As the staple 1432 is fired (i.e.,driven in the distal direction “DD” by the staple driver 1440) throughmovement of the movable handle portion 24 of the surgical instrument 10,it is formed as it contacts a staple-forming anvil 1490 non-movablymounted within the housing 1410. FIG. 10 illustrates the surgical tool1400 prior to firing. FIG. 11 illustrates firing a staple 1432 into thetissue “T”. FIG. 12 illustrates the staple driver 11440 after is hasbeen retracted to permit another staple 1432 to drop into a readyposition. While the surgical tool 1400 is particularly well-suited forendoscopic procedures, those of ordinary skill in the art will alsoappreciate that the surgical tool 1400 may also be used to staple openincisions that do not require the surgical tool 1400 to be insertedthrough a cannula into a body cavity.

FIGS. 13 and 14 illustrate another surgical tool 1500 that may be usedwith the conventional surgical instrument 10. As can be seen in thoseFigures, the surgical tool 1500 comprises a syringe for deploying, forexample, glue, sealant, a drug or other medicament. More particularlyand with reference to FIG. 14, the surgical tool 1500 may include ahousing portion 1500 that has a proximal end portion 1512 that isconfigured for removable attachment to the elongated body 14 of thesurgical instrument 10. In particular, the proximal end portion 1512 mayhave engagement nubs 254 formed thereon which serve to form abayonet-type coupling with the distal end of the elongated body portion14 of the surgical stapling instrument 10 as described above. Thesurgical tool 1500 may include a drive assembly 1520 that comprises anelongated drive beam 1522 that may be constructed from a single sheet ofmaterial or, preferably, from multiple stacked sheets. However, drivebeam 1522 may be fabricated from other suitable materials andarrangements. As can be seen in FIG. 14, the drive beam 1522 has anengagement section 1524 formed thereon that may include a pair ofengagement fingers 1524 a and 1524 b that are dimensioned and configuredto mountingly engage a drive member 1526. Drive member 1526 includes aproximal porthole 1528 configured to receive the distal end 276 ofcontrol rod 52 (See FIG. 1) when the proximal end 1512 of the surgicaltool 1500 is coupled to the elongated body 14 of surgical instrument 10.As can be seen in FIG. 14, the proximal end 1512 has a hollow passage1514 therein through which the distal end 276 of the control rod 52 mayextend.

As can also be seen in FIGS. 13 and 14, a syringe body 1570 is attachedto a distal end 1516 by a collar 1572 or other fastener arrangement. Thecollar 1572 may be affixed to the housing 1510 and syringe body 1570, byadhesive or other suitable arrangements. As can be seen in FIG. 14, adistal end 1523 of the drive beam 1522 is attached to a syringe plunger1574 that is movably supported within the syringe body 1570. A hollowneedle or cannula 1580 may be attached to the distal end of the syringebody 1570 as shown. The syringe body 1570 may be filled with a drug ormedicament by first advancing the syringe plunger 1574 to the distal endof the syringe body 1570 by moving the movable handle 24 of the surgicalinstrument 10 (FIG. 1) toward the stationary handle portion 22 of thehandle assembly 12. Thereafter, the pointed end 1582 of the needle 1580may be inserted into a vial or reservoir of glue, sealant, drug ormedicament (not shown). The clinician may then draw the material fromthe reservoir into the syringe body 1570 through the needle 1580 bymoving the movable handle 24 away from the stationary portion 22 of thehandle assembly 12 which serves to move the drive beam 1522 and thesyringe plunger 1574 in the proximal direction “PD”. Once the desiredamount of drug or medicament has been drawn into the syringe body 1574,the clinician may then insert the surgical tool 1500 into the bodycavity through a cannula or other opening and then expel the drug ormedicament from the syringe body 1570 by again moving the movable handle24 toward the stationary handle portion 22 of the handle assembly 12. Ascale or other form of measuring indicia 1590 may be provided on thesyringe body 1570 to enable the clinician to monitor the amount of glue,sealant, drug or medicament that has been discharged from the syringebody 1574.

When a surgical procedure involves stapling of tissue, the clinicianmust select the proper size of staple to use based upon the thickness ofthe tissue to be stapled. For example, staples that are commonly usedfor endoscopic procedures are generally manufactured in various sizes toprovide various formed heights such as 0.75 mm, 1.0 mm, 1.5 mm, 2.0 mm,etc. The clinician must carefully match the size of the staple to thethickness of the tissue. If the staple is too large, the tissue may notbe held together properly or if the staple is too small, it may tearthrough the tissue. In the past, however, the clinician often would haveto estimate the tissue thickness and then hope that the estimate wassufficiently accurate. Thus, there is a need for a surgical tool thatcould be used in connection with a surgical instrument 10 that canaccurately measure tissue thickness so that the appropriate size ofstaples may be used.

FIGS. 15-30 depict a surgical tool embodiment 1600 of the presentinvention that may be operably coupled to the surgical instrument 10 andused to measure the thickness of tissue “T” that may need to be cut andstapled. As can be seen in those Figures, the surgical tool 1600 mayinclude a carrier 216 that has a housing 1610 attached thereto. Thehousing 1610 may be attached to the upstanding walls 217 of the carrier216 by snap features 219 or other suitable means. The housing 1610 has aproximal end 1612 that is configured for removable attachment to theelongated body 14 of the surgical instrument 10. In particular, theproximal end 1612 may have engagement nubs 254 formed thereon whichserve to form a bayonet-type coupling with the distal end of theelongated body portion 14 of the surgical instrument 10 as was describedabove.

The surgical tool 1600 further includes a drive assembly 1620 thatincludes a drive beam 1622 that may be constructed from a single sheetof material or, preferably, from multiple stacked sheets. However, drivebeam 1622 may be fabricated from other suitable materials andarrangements. As can be seen in FIG. 16, the drive beam segment 1622 hasan engagement section 1624 formed thereon that may include a pair ofengagement fingers 1624 a and 1624 b that are dimensioned and configuredto mountingly engage a drive member 1626. Drive member 1626 includes aproximal porthole (not shown) to receive the distal end 276 of controlrod 52 (See FIG. 1) when the proximal end 1612 of surgical tool 1600 iscoupled to the elongated body 14 of the surgical instrument 10.

The distal end 1626 of the drive beam 1622 may have a camming pin orroller 286 (FIG. 16) arranged to engage a camming portion 209 (FIG. 18)of a non-staple forming anvil assembly 20 that is pivotally coupled tothe carrier 216. A pair of pivot members 211 are formed on the anvilassembly 20 and are positioned within slots 213 formed in carrier 216 toguide the anvil portion between the open and clamped positions. As thedrive beam 1622 is driven in the distal direction “DD” by moving themovable handle 24 toward the stationary handle portion 22 of the handleassembly 12 of the surgical instrument 10, the camming roller on thedistal end of the drive beam 1622 engages the camming portion 209 of theanvil assembly 20 and causes the anvil assembly 20 to pivot to a givenand repeatable closed position which forms a reference surface forestablishing a thickness measurement.

The surgical tool 1600 may further include a tissue thickness measuringcartridge 1650 that is supported within the carrier 216. As can be seenin FIGS. 18-22, the thickness measuring cartridge 1650 includes a bodyportion 1652 that is mounted within the carrier 216 and retained thereinby snap features 1654 (FIG. 22) or other appropriate fastenerarrangements. As can be seen in FIG. 22, for example, the cartridge body1652 may be fabricated from two body segments 1652 a, 1652 b that may befastened together by adhesive or other appropriate fasteners. As can befurther seen in FIG. 22, the cartridge body 1652 operably supports amovable tissue measuring platform 1660. Tissue platform 1660 may beconfigured as shown in FIGS. 22 and 23 and have a proximal end portion1662 that is coupled to the cartridge body portion 1652 by a hinge pin1664. A platform spring 1666 may be journaled on the hinge pin 1664 tobias the tissue platform 1660 in a direction toward the anvil assembly20 (represented by arrow “U” in FIGS. 17 and 19). The hinge pin 1664 maybe mounted within corresponding holes 1653 in the body segments 1652 a,1652 b. See FIG. 22. As can also be seen in FIGS. 23 and 26-30, thedistal end 1668 of the tissue plate 1660 has a downwardly protrudinggear rack segment 1669 thereon that is adapted to drivingly interfacewith a gear assembly 1670.

As can be seen in FIGS. 22 and 23, gear assembly 1670 may include afirst rack gear 1672 that is keyed onto a first gear shaft 1680 that isrotatably supported in holes 1682 in the body segments 1652 a, 1652. Asecond step gear 1674 may also be keyed onto the first gear shaft 1680.The gear assembly 1670 may further include a third transfer gear 1676that is keyed onto a second gear shaft 1690 that is rotatably supportedin holes 1692 in the body segments 1652 a, 1652 b and in meshingengagement with the second step gear 1674. A fourth output gear 1678 isalso keyed onto the second gear shaft 1690 and is in meshing engagementwith a gear rack portion 1702 of an indicator member or base 1700 thatis slidably supported in the carrier 216. Thus, as can be appreciatedfrom reference to FIG. 27, as the tissue platform 1660 is depresseddownward (arrow “DW”), the gear rack segment 1669 protruding therefromcauses the first rack gear 1672 to rotate counterclockwise “CCW” in FIG.27 which also causes the second step gear 1674 to also rotate in thecounterclockwise direction. The second step gear 1674 is in meshingengagement with the third transfer gear 1676 and is caused to rotate inthe clockwise “CW” direction in FIG. 27. As the third transfer gear 1676rotates clockwise, so does the output gear 1678. As the output gear 1678rotates clockwise (“CW”), it drives the indicator base 1700 in thedistal direction “DD” by virtue of its meshing engagement with theindicator rack 1702. In various embodiments, for example, a gear ratioof approximately 30 to 1 may be employed such that 60 mm of linearfiring motion is accomplished in approximately 3 seconds. However, othergear ratios could conceivably be employed.

As can be most particularly seen in FIG. 23, the indicator base 1700 maybe bifurcated into two lateral indicator leg portions 1710 that eachterminate in an upstanding indicator plate 1712. Each indicator plate1712 may have a series of thickness identifiers or indicators thereon.In particular, each indicator plate 1712, may have a first thicknessidentifier 1720 that corresponds to a first tissue thickness range “T1”.For example, the first tissue thickness range “T1” may represent tissuehaving a thickness of about 75 mm to about 1.0 mm which would require aformed staple size of 0.75 mm. Each indicator plate 1712 may furtherhave a second thickness identifier 1722 that corresponds to a secondtissue thickness range “T2”. For example, the second tissue thicknessrange “T2” may be for tissue having a thickness of about 1.0 mm to about1.5 mm which would require a formed staple size of, for example, 1.0 mm.Each indicator plate 1712 may further have a third tissue thicknessidentifier 1724 that corresponds to a third tissue thickness range “T3”that corresponds to a third particular size of tissue. For example, thethird thickness range “T3” may be for tissue having a thickness of about1.5 mm to 2.0 mm which would require a formed staple size of, forexample, 1.5 mm. Each indicator plate 1712 may further have a fourthtissue thickness identifier 1726 that corresponds to a fourth tissuethickness range “T4” that corresponds to a fourth particular size oftissue. For example, the fourth tissue thickness range “T4” may be fortissue having a thickness of about 2.0 mm which would require a formedstaple size of, for example, 2.0 mm. The tissue identifiers 1720, 1722,1724, 1726 may comprise, for example, numbers, letters, colors, etc.that are each understood to correspond to a particular tissue thicknessrange. In various embodiments, a proximal tissue stop 1721 may beprovided on the cartridge 1652 to provide an abutment wall to positionthe tissue between the cartridge 1652 and the anvil assembly 20. SeeFIGS. 17, 22, and 24. Also in various embodiments, tissue grip members1723 may be provided on the cartridge 1652 as shown in FIG. 22 to assistwith the gripping and positioning of tissue between the cartridge 1652and the anvil assembly 20.

As can be seen in FIG. 25, a view window 1730 may be provided in eachlateral side portion of the housing 1610 to coincide with the tissueidentifiers 1720, 1722, 1724, 1726 as will be discussed in furtherdetail below. FIGS. 18 and 19 illustrate the positions of the indicatorplates 1712 when no tissue has been clamped between the anvil assembly20 and the tissue platform 1660. As can be seen in those Figures, noneof the thickness indicators 1720, 1722, 1724, 1726 can be observedthrough the viewing windows 1730. FIGS. 26 and 27 illustrate thepositions of the indicator plates 1712 when tissue having a tissuethickness range T1 is clamped between the anvil assembly 20 and thetissue platform 1660. As can be see in those Figures, the first tissueindicator 1720 is viewable through the corresponding window 1730.

FIG. 28 illustrates the positions of the indicator plates 1712 whentissue having a tissue thickness range T2 is clamped between the anvilassembly 20 and the tissue platform 1660. As can be see in that Figure,the second tissue indicator 1722 is viewable through the correspondingwindow 1730. FIG. 29 illustrates the positions of the indicator plates1712 when tissue having a tissue thickness range T3 is clamped betweenthe anvil assembly 20 and the tissue platform 1660. As can be see inthat Figure, the third tissue indicator 1724 is viewable through thecorresponding window 1730. FIG. 30 illustrates the positions of theindicator plates 1712 when tissue having a tissue thickness range T4 isclamped between the anvil assembly 20 and the tissue platform 1660. Ascan be see in that Figure, the fourth tissue indicator 1726 is viewablethrough the corresponding window 1730. Thus, by operably attaching thesurgical tool 1600 to the surgical instrument 10 and clamping a portionof target tissue to be stapled between the tissue platform 1660 andanvil assembly 20 (by activating the movable handle portion 24 towardthe stationary handle portion 22), the clinician can ascertain theapproximate thickness of the tissue to be stapled and then select adisposable stapling unit of for example, the type disclosed in U.S. Pat.No. 5,865,361 with the appropriate sized staples. The clinician thensimply detaches the surgical tool 1600 from the surgical instrument 10and then operably attaches the selected disposable stapling unit to thesurgical instrument 10 and operates it as described in U.S. Pat. No.5,865,361.

FIGS. 31-35 illustrate another surgical tool embodiment 1800 thatcomprises a clip applier for use with a surgical instrument 10 to applyat least one surgical clip 1801 to a human body. Various embodiments ofthe surgical tool 1800 may employ various components of the clipappliers disclosed in U.S. Pat. No. 5,951,574, entitled MULTIPLE CLIPAPPLIER HAVING A SPLIT FEEDING MECHANISM, issued Sep. 14, 1999, thedisclosure of which is herein incorporated by reference. The use ofsurgical clips 1801 to ligate structures within the body such asvessels, ducts, and tissue is well known in the surgical art. Variousembodiments of the surgical tool 1800 may have a distal pair of opposedmoveable jaws 1820 for receiving clips 1801 serially therein when thejaws 1820 are open and forming the clip 1801 received serially thereinwhen the jaws 1820 are closed. See FIG. 33. The jaws 1820 may beconnected to a distal end of a generally rectangular shaft 1830 thatprotrudes from a housing assembly 1840. The shaft 1830 may have astructural “U” shaped outer wrap 1832, a transparent upper shroud 1834,and a clip magazine containing a plurality of clips (not shown) locatedtherein.

The housing assembly 1840 may include a base portion 1842 that has acover 1844 attached thereto. See FIG. 34. The base portion 1842 has aproximal end 1846 that is configured for operable attachment to theelongated body 14 and the control rod 52 of the surgical instrument 10.The proximal end portion 1846 has a hollow connector portion 1848 thatincludes engagement nubs 254 for releasably engaging elongated body 14of the surgical instrument 10.

The instrument 1800 may further include a firing rod connector 1850 thathas a porthole 1852 therein for receiving the distal end 276 of thecontrol rod 52. See FIG. 34. The firing rod connector 1850 is coupled toa forming plate 1860 that may be otherwise similar in construction tothe forming mechanism 85 disclosed in U.S. Pat. No. 5,951,574, exceptfor the differences discussed herein. As can be seen in FIGS. 31-33 and35, the forming plate 1860 may have a forming rack 1862 thereon formeshing engagement with a gear assembly 1870. The gear assembly 1870 maybe rotatably supported on a gear post 1872 that protrudes from the baseportion 1842 and extends through an elongated slot 1864 in the formingplate 1860. The gear assembly 1870 may have a forming gear portion 1874that is in meshing engagement with the forming rack 1862. The gearassembly 1870 may also comprise a feed gear 1876 that is attached to theforming gear 1874. The feed gear 1876 is in meshing engagement with afeed rack 1882 formed on a feed plate 1880 which performs the samefunctions as the feed mechanism 100 of U.S. Pat. No. 5,951,574. Invarious embodiments, the gear assembly 1870 and gear racks 1862, 1882may have a 2:1 gear ratio, such that as the forming plate 1860 is drivenin a distal direction “DD”, the feed plate 1880 is simultaneously drivenin the proximal direction “PD” only half as far as the forming plate1860 was driven in the distal direction “DD”.

The surgical tool 1800 also has a clip pusher 1890 (FIG. 33) thatremains generally stationary throughout most of the simultaneous motion.The clip pusher 1890 is releasably coupled to the moving feed plate 1880as the control rod 52 moves the feed plate 1880 in a proximal directionfor the placement of a clip 1801 into the opening jaws 1820. The clipmagazine within the shaft 1830 supplies additional clips 1801 to thefeed plate 1880 and clip pusher 1890 for serial placement of the clips1801 into the jaws 1802.

The surgical tool 1800 is activated by moving the control rod 52 in thedistal direction “DD” which causes the closure of the jaws 1820 and theformation of each of the clips 1801 received serially therein. Movingthe control rod 52 in the proximal direction “PD” opens the jaws 1820,releases the fully formed clip 1801, and feeds an unformed clip 1801serially into the open jaws 1820. The surgical tool 1800 is coupled tothe elongated body portion 14 and the control rod 52 in the mannerdescribed above and is operated by moving the movable handle portion 24toward and away from the stationary handle portion 22 as was alsodescribed above. The person of ordinary skill in the art will understandthat the surgical tool 1800 is especially adapted for use in opensurgical applications thereby expanding the use of the conventionalsurgical instrument 10 which, in the past, has been limited to use inconnection with endoscopic surgical procedures.

The tool assemblies of the prior disposable loading units that have beendesigned for use with the conventional surgical instrument 10 areconfigured to deploy staples in straight lines. During many surgicaltechniques, such as the resection of stomach tissue, for example, such alinear deployment is often preferred. During these techniques, thedisposable loading unit is typically inserted through a cannula toaccess the surgical site and, as a result, it is often desirable for thetool assembly thereof to have a linear configuration that can be alignedwith an axis of the cannula before the tool assembly is insertedtherethrough. However, in some circumstances, those tool assemblies thathave such a linear configuration are somewhat difficult to use. Moreparticularly, for example, when the tool assembly must be placedadjacent to or against a cavity wall, such as the thoracic cavity wall,for example, it is often difficult for the surgeon to position a jaw ofthe tool assembly behind delicate or fragile tissue which is proximal toand/or attached to the cavity wall. Furthermore, even if the surgeon issuccessful in positioning a jaw behind the tissue, owing to the linearconfiguration of the tool assembly, the surgeon may not be able to seethe distal end of the tool assembly. In some circumstances, surgicalinstruments that have a reusable blade and drive system have beendeveloped to employ curved end effectors. Examples of such devices aredisclosed in commonly-owned U.S. patent application Ser. No. 11/652,170,filed Jan. 11, 2007 and entitled SURGICAL STAPLER END EFFECTOR WITH ATAPERED DISTAL END, now U.S. Patent Application Publication No.2008/0169333, the disclosure of which has been herein incorporated byreference.

FIG. 36 depicts another surgical tool embodiment 1900 of the presentinvention that may be used in connection with a surgical instrument 10.As can be seen in that Figure, the surgical tool 1900 may include acurved carrier 1916 that has a housing member 1910 attached thereto. Thehousing 1910 may be attached to the upstanding walls 1917 of the carrierportion by snap features or other suitable means. The housing member1610 has a proximal end 1912 that is configured for removable attachmentto the elongated body 14 of the surgical instrument 10. In particular,the proximal end 1912 may have engagement nubs 254 formed thereon whichserve to form a bayonet-type coupling with the distal end of theelongated body portion 14 of the surgical instrument 10 as was describedabove.

In various embodiments of the present invention, the carrier 1916 andthe staple cartridge 1920 supported therein are curved. In variousembodiments, for example, the curvature of those components can beconfigured to substantially match the contour of a typical thoraciccavity wall. In these embodiments, the curvature of several thoraciccavity walls can be measured and statistically analyzed to determine theoptimum profile of the curved end-effector. This profile can includeseveral arcuate portions and, in addition, several linear portions. Inother embodiments, the curvature of the thoracic cavity wall can beapproximated by a single radius of curvature. Such embodiments can besimpler and less expensive to manufacture. In at least one embodiment,this radius of curvature is 1.2″. In other various embodiments, thecurvature of the carrier 1916 and staple cartridge 1920 can beconfigured to match the profile of the lower rectum, pelvis, or lowerabdomen. FIG. 37 illustrates, for example, an alternative surgicalinstrument 1900′ that employs a carrier 1916′ that has a curvature thatdiffers from the curvature of carrier 1916. Other curvatures disclosedin the aforementioned U.S. patent application Ser. No. 11/652,170, nowU.S. Patent Application Publication No. 2008/0169333, may also beemployed.

In various embodiments of the present invention, the staple cartridge1920 includes a curved slot 1922 for controlling the movement of axialdrive assembly 1966 along a curved path. This curved slot 1922 caninclude several arcuate portions and several linear portions. In variousembodiments, the curved slot 1922 can be defined by one radius ofcurvature. The anvil assembly 1930 which may otherwise be similar to theanvil assemblies described above, may have a curved portion (omitted forclarity in FIGS. 36 and 37) that substantially matches the curvature ofthe carrier 1916 and the staple cartridge 1920. In the embodimentsillustrated in FIGS. 36 and 37, the staple cartridge 1920 has a curvedslot 1922. The carrier 1916 and the anvil assembly may each have anidentical slot (not shown) therein that, in connection with the slot1922 are configured to receive a corresponding portion of a drive beam1966 therein. The proximal end of the drive member 1966 may beconfigured in the above described manner with respect to drive beam 1622to facilitate its driving activation by movement of the control rod 52as described above. The distal end of the drive beam 1966 containing theblade (not shown) may be configured such that, as the drive beam 1966 isdriven in the distal direction “DD” by movement of the movable handle 24of the surgical instrument 10, the drive beam 1966 tracks the curvedpath defined by the slot 1922.

FIGS. 38 and 39 depict a surgical tool embodiment 2000 of the presentinvention that may be coupled to the surgical instrument 10 and used tocauterize tissue in an open surgical setting. As can be seen in thoseFigures, the surgical tool 2000 may include a housing 2010 that has aproximal end 2011 that is configured for removable attachment to theelongated body 14 of the surgical instrument 10. In particular, theproximal end 2011 may have engagement nubs 254 formed thereon whichserve to form a bayonet-type coupling with the distal end of theelongated body portion 14 of the surgical instrument 10 as was describedabove.

The housing 2010 may further include a switch portion 2013 that movablyhouses a battery 2030 therein. The movable battery 2030 may be of thetype and construction disclosed in commonly-owned U.S. patentapplication Ser. No. 12/031,628, filed Feb. 14, 2008, entitledDISPOSABLE MOTOR DRIVEN LOADING UNIT FOR USE WITH A SURGICAL CUTTING ANDSTAPLING APPARATUS, now U.S. Pat. No. 7,793,812, which is hereinincorporated by reference. More specifically and with reference to FIG.39, the switch portion 2013 of the housing 2010 defines a battery cavity2032 that movably supports a battery holder 2034 that houses the battery2030 therein. As can be seen in FIG. 39, a first battery contact 2036 issupported in electrical contact with the battery 2030 and protrudes outthrough the battery holder 2034 for sliding engagement with the insidewall 2033 of the battery cavity 2032. Similarly, a second batterycontact 2038 is mounted in electrical contact with the battery 2030 andalso protrudes out of the battery holder 2034 to slide along the insidewall 2033 of the battery cavity 2032. The battery holder 2034 has acontrol rod socket 2035 therein configured to receive the distal end 276of control rod 52 when the proximal end 2011 of the surgical tool 2000is coupled to the elongated body 14 of surgical stapling apparatus 10.As can also be seen in FIG. 39, a pair of contacts 2026, 2028 may beoriented within the wall 2033 for contact with the battery contacts2036, 2038, respectively. The purpose of the contacts 2026, 2028 will bediscussed in further detail below. As can also be seen in FIG. 39, abiasing member or switch spring 2040 is positioned within the batterycavity 2032 to bias the battery holder 2034 in the proximal direction“PD” such that when the surgical tool 2000 is not attached to theelongated body 14, the battery holder 2034 is biased to itsproximal-most position shown in FIG. 39. When retained in that “pre-use”or “disconnected” position by spring 2040, the battery contacts 2036 and2038 do not contact their respective contacts 2026, 2028 within thebattery cavity 2032 to prevent the battery 2030 from being drainedduring non-use.

As can be seen in FIG. 38, the surgical tool 2000 may further include anon-staple applying end effector in the form of a ball-shaped end member2050 that may be pivotally pinned to a yoke 2052 that is coupled to thedistal end of the housing 2010. In various embodiments, the end effector2050 may be fabricated from a conductive material such as stainlesssteel, titanium, etc. and have at least one electrically powered member2060 therein. In the embodiment depicted in FIG. 38, the electricallypowered member 2060 may comprise a heating element. Those of ordinaryskill in the art will appreciate that the end-effector 2050 may beprovided in a myriad of other shapes and configurations withoutdeparting from the spirit and scope of the present invention. As can befurther seen in FIG. 38, the heating element 2060 may be electricallycoupled to contacts 2026, 2028 by leads 2022, 2024, respectively.

Thus, when the surgical tool 2000 is unattached to the elongated body 14of the surgical instrument 10, the battery 2030 will be biased into anunactuated position (FIG. 39) and therefore not be drained. In addition,attachment of the surgical tool 2000 to the elongated body 14 (andattachment of the control rod 52 to the battery holder socket 2035 willnot result in the operation or draining of the battery 2030. To use thetool 2000, the clinician simply moves the movable handle 24 toward thestationary portion 22 of the handle assembly (FIG. 1) to drive thebattery contacts 2036, 2038 into contact with contacts 2026, 2028,respectively which then powers the heating element 2060 in the endeffector 2050. A light or other indicator 2070 may be supported by thehousing 2010 and powered by the battery 2030 to provide the clinicianwith an indication that the heating element 2060 is being powered.

FIG. 40 illustrates another surgical tool embodiment 2000′ that issubstantially similar to the surgical tool 2000 described above.However, in this embodiment, the surgical tool 2000′ does not have abattery therein. The surgical tool 2000′ is constructed for use with asurgical instrument 10′ that has a battery 2030′ that is operated by aswitch 2090 that is mounted in the handle assembly 12′. The switch 2090communicates with a contact assembly 2092 that is located in the distalend of the elongated body 14. The contact assembly 2092 is oriented tocontact a contact 2094 mounted on the proximal end of the housingportion of tool 2000′ when the tool 2000′ is coupled to the elongatedbody 14. To activate the heating element 2060 in the end effector 2050,the clinician activates the button 2090 on the handle assembly 12′. Alight 2070′ may also be mounted on the handle assembly 12′ to provide anindication of when the tool 2000′ is being powered.

FIGS. 41 and 42 illustrate alternative housing embodiments 2200 and2200′ that may be used in place of the various housing arrangementsdescribed above when flexible drive assemblies are employed. Inparticular, these housings 2200, 2200′ may at least be employed inconnection with the various embodiments depicted in FIGS. 2-30 and 36-40when drive assemblies that are capable of flexing or at least haveportions that are capable of flexing are employed. The housing 2200depicted in FIG. 41 may be configured as shown with a proximal endportion 2202 that is configured to receive the distal end of the controlrod 52 therein and that has nubs 254 thereon to facilitate attachment tothe elongated body 14 as was described above. In this embodiment,however, housing 2200 has a passive articulation joint member 2300formed therein that facilitates passive articulation about thelongitudinal axis L-L of the housing 2200 as shown. The passivearticulation joint member 2300 may comprise a flexible conduit section2302 that has interlocking ribs 2304 that are constructed to retain thepassively articulated joint 2300 in an articulated orientation.

FIG. 42 illustrates another articulatable housing 2200′ that has anotherpassive articulation joint member 2300′ that is coupled to a proximalhousing portion 2400 by, for example, a proximal body collar 2310. Theflexible articulation member 2300′ has a body portion 2301 and include aplurality of kerfs 2302 separated by ribs 2304. In various embodiments,the kerfs 2303 and ribs 2304 may be equally spaced along the flexiblearticulation member 2300′ thereby promoting a continuous bend radiuswhen the flexible articulation member is articulated. A flexiblearticulation member 2300′ having multiple bend radii may be achieved byproviding unequal spacing between the kerfs 2303 and the ribs 2304. Forexample, such arrangement may be achieved by spacing the ribs 2304 moreclosely at one end and farther apart at the other end. As will beappreciated by those of ordinary skill in the art, increasing thespacing of the kerfs 2303 and/or the ribs 2304 reduces the bend radiusof the section having increased spacing, more closely approximating apivot point bend connection. Conversely spacing the kerfs 2303 and/orribs 2304 more closely results in a more gradual bend, having a largerbend radius.

In the embodiment illustrated in FIG. 42, the kerfs 2302 compriseannular grooves that extend at least partially around the perimeter ofthe flexible articulation member 2300′. The kerfs 2302 preferably,however, comprise semi-annular grooves which are separated by a centrallongitudinal spine 2306 passing down the longitudinal axis L-L of theflexible articulation member 2300′ such that a first plurality of ribsare formed on one lateral side of the spine 2306 and a second pluralityof ribs 2304 are formed on another lateral side of the spine 2306. Thisspine 2306 assists in providing stiffening to the flexible articulationmember 2300′ and accommodates a slot (not shown) for receiving a driveassembly therethrough. The longitudinal spine 2306 may run the entirelongitudinal length of the flexible articulation member 2300′. Theflexible articulation member 2300′ may also include a pair of side slot(not shown) passing through each rib 2304 on each lateral side forreceiving a corresponding articulation plate (not shown) as discussed incommonly-owned U.S. patent application Ser. No. 12/031,001, entitledARTICULATABLE LOADING UNITS FOR SURGICAL STAPLING AND CUTTINGINSTRUMENT, filed on Feb. 14, 2008, now U.S. Patent ApplicationPublication No. 2009/0206133, the disclosure of which is hereinincorporated by reference. As discussed therein, such articulationplates may be fabricated from a material that is relatively inelastic.That is, the plates may be fabricated from a material that retains itsposition after bending. Articulation plates may, for example, befabricated from materials such as lead, copper, etc. Those of ordinaryskill in the art will understand that at least a flexible or otherwisearticulatable portion of a drive assembly supported within either of thehousings 2300, 2300′ is positioned to correspond with the flexiblearticulation member 2300, 2300′ to facilitate articulation of thesurgical tool without adversely affecting the operation of the driveassembly extending therethrough.

Thus, as will be appreciated by the foregoing, the various surgical toolembodiments of the present invention are especially suited for use withsurgical instruments that were specifically designed for use inconnection with disposable cutting and stapling units that have theirdedicated cutting blade and are constructed to be disposed of after asingle use. While such instruments may be commonly used in connectionwith multiple disposable cutting and stapling units, a clinician wouldhave to have on hand several other dedicated instruments to performother procedures during an operation. The interchangeable tool system ofthe present invention solves that problem. Thus, various embodiments ofthe present invention may comprise a surgical tool system that mayinclude the surgical instrument 10 and at least two of the varioussurgical tools disclosed herein. For example, the surgical tools maycomprise a manipulator 1000, nippers 1200, scissors 1300, a disposableendocutter 16, a tissue thickness measurement device 1600, stapleappliers 1400, clip appliers 1800, cauterization devices 2000 andspecimen retrieval devices 1100.

While several embodiments of the invention have been described, itshould be apparent, however, that various modifications, alterations andadaptations to those embodiments may occur to persons skilled in the artwith the attainment of some or all of the advantages of the invention.For example, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Thisapplication is therefore intended to cover all such modifications,alterations and adaptations without departing from the scope and spiritof the disclosed invention as defined by the appended claims.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

The invention which is intended to be protected is not to be construedas limited to the particular embodiments disclosed. The embodiments aretherefore to be regarded as illustrative rather than restrictive.Variations and changes may be made by others without departing from thespirit of the present invention. Accordingly, it is expressly intendedthat all such equivalents, variations and changes which fall within thespirit and scope of the present invention as defined in the claims beembraced thereby.

What is claimed is:
 1. A surgical tool for use with a surgicalinstrument including a handle assembly and an elongated body defining alongitudinal axis and a drive system configured to generate drivemotions, said surgical tool comprising: a carrier removably couplable tothe elongated body; an anvil movably supported for selective movementrelative to said carrier in response to drive motions from the drivesystem of the surgical instrument to selectively move said anvil towardand away from said carrier; a tissue thickness measuring member movablysupported in said carrier and configured to move toward and away from anunderside of said anvil in a direction that is transverse to thelongitudinal axis; and a sensor arrangement supported between saidtissue thickness measuring member and said carrier and being configuredto interface with an indicator member to provide an indication of athickness of tissue clamped between said anvil and said tissue thicknessmeasuring member at a location on said surgical tool that is proximal tosaid anvil when in use.
 2. The surgical tool of claim 1, wherein saidcarrier is coupled to a housing portion that is removably couplable tosaid elongated body.
 3. The surgical tool of claim 2, wherein saidtissue thickness measuring member further comprises: a cartridge bodysupported in said carrier; and a tissue measuring platform movablysupported relative to said cartridge body for movable travel relativethereto in said direction that is transverse to the longitudinal axis.4. The surgical tool of claim 3, further comprising an indicator basemovably supported by said cartridge body for axial travel relativethereto and wherein said sensor arrangement comprises a gear assemblysupported by said cartridge body and operably interfacing with saidtissue measuring platform and said indicator base, such that movement ofsaid tissue measuring platform causes said indicator base to moveaxially relative to said cartridge body.
 5. The surgical tool of claim4, wherein said indicator base has a plurality of thickness identifiersthereon corresponding to particular tissue thicknesses and viewablethrough a window in said housing portion when tissue having saidcorresponding amount of tissue thickness is clamped between said anviland said cartridge body.
 6. The surgical tool of claim 5, wherein saidhousing portion has a first lateral side and a second lateral side andwherein said indicator base has a plurality of first and secondthickness identifiers thereon corresponding to particular tissuethicknesses wherein said first thickness identifiers are viewablethrough a first window in said first lateral side of said housingportion when tissue having said corresponding amount of tissue thicknessis clamped between said anvil and said cartridge body and wherein saidsecond thickness identifiers are viewable through a second window insaid second lateral side of said housing portion when tissue having saidcorresponding amount of tissue thickness is clamped between said anviland said cartridge body.
 7. The surgical tool of claim 2, wherein saidtissue thickness measuring member comprises: a cartridge body supportedin said carrier; and a tissue measuring platform pivotably coupled tosaid cartridge body for pivotal travel relative thereto about a pivotaxis that is transverse to the longitudinal axis.
 8. The surgical toolof claim 2, wherein said housing portion comprises a bayonet couplingconfiguration at a proximal end thereof for removable attachment to adistal end of the elongated body.
 9. The surgical tool of claim 8,wherein said indicator member is configured to provide said indicationof the thickness of tissue clamped between said anvil and said tissuethickness measuring member at a location on said housing portion betweensaid anvil and said bayonet coupling configuration.
 10. Atissue-measuring unit for use with a surgical instrument comprising adrive system configured to be removably coupled to a disposable loadingunit configured to cut and staple tissue, said tissue-measuring unitcomprising: a housing comprising a bayonet coupling feature configuredto be coupled to the drive system of the surgical instrument anddefining a longitudinal axis; a carrier coupled to said housing; a firstmember movably supported distal to said housing for selective movementrelative to said carrier in response to closure motions from thesurgical instrument; and a tissue thickness measuring cartridgecomprising a tissue measuring platform movably supported in said carrierand configured to move toward and away from an underside of said firstmember in a direction that is transverse to said longitudinal axis, saidtissue thickness measuring cartridge further comprising an indicatormember to provide an indication of a thickness range of tissue clampedbetween said first member and said tissue thickness measuring cartridgesuch that said indicator member is viewable through a location on saidhousing that is proximal to said first member.
 11. The tissue-measuringunit of claim 10, further comprising: a cartridge body supported in saidcarrier; and a tissue measuring platform movably supported relative tosaid cartridge body for movable travel relative thereto in saiddirection transverse to said longitudinal axis.
 12. The tissue-measuringunit of claim 10, further comprising: a cartridge body supported in saidcarrier; an indicator base movably supported by said cartridge body foraxial travel relative thereto; and a gear assembly supported in saidcartridge body and operably interfacing with said tissue measuringplatform and said indicator base, such that movement of said tissuemeasuring platform causes said indicator base to move axially relativeto said cartridge body.
 13. The tissue-measuring unit of claim 11,further comprising at least one tissue gripping feature protruding fromsaid cartridge body.
 14. The tissue-measuring unit of claim 10, whereinsaid tissue thickness measuring cartridge further comprises a cartridgebody that is configured to be removably supported in said carrier andwherein said tissue measuring platform is pivotably coupled to saidcartridge body for pivotal travel relative thereto about a pivot axisthat is transverse to said longitudinal axis.
 15. The tissue-measuringunit of claim 12, wherein said housing has a first lateral side and asecond lateral side and wherein said indicator base has a plurality offirst and second thickness identifiers thereon corresponding toparticular tissue thicknesses wherein said first thickness identifiersare viewable through a first window in said first lateral side of saidhousing when tissue having said corresponding amount of tissue thicknessis clamped between said first member and said cartridge body and whereinsaid second thickness identifiers are viewable through a second windowin said second lateral side of said housing when tissue having saidcorresponding amount of tissue thickness is clamped between said firstmember and said cartridge body.
 16. The tissue-measuring unit of claim12, wherein said indicator base has a plurality of thickness identifiersthereon corresponding to particular tissue thicknesses and viewablethrough a window in said housing when tissue having said correspondingamount of tissue thickness is clamped between said first member and saidcartridge body.
 17. A surgical tool for use with a surgical instrumentincluding a handle assembly and an elongated body defining alongitudinal axis, said surgical tool comprising: a first jaw; and asecond jaw assembly operably interfacing with the elongated body andbeing operably coupled to said first jaw at an attachment location suchthat said first jaw is selectively movably relative to said second jawassembly between open and closed positions in response to controlmotions applied thereto from the elongated body and wherein said secondjaw assembly comprises: a non-movable portion; a deflectable portionsupported for deflection toward said non-movable portion in a directionthat is transverse to the longitudinal axis upon clamping of tissuebetween the deflectable portion and the first jaw; and a sensorarrangement supported between said non-movable portion and saiddeflectable portion to provide an indication of a thickness of thetissue being clamped between said first jaw and said deflectable portionsuch that said indication is viewable at a location on said surgicaltool that is proximal to said attachment location when in use.
 18. Asurgical system, comprising: a first jaw comprising a tissue compressionsurface; and a second jaw, wherein said first jaw and said second jaware connected to one another at a rotation joint, and wherein saidsecond jaw comprises: a frame portion defining a longitudinal axis; adeflectable portion positioned intermediate said tissue compressionsurface of said first jaw and said frame portion of said second jaw,wherein said deflectable portion is configured to deflect in a directionthat is transverse to said longitudinal axis in response to closure ofsaid first jaw onto tissue situated between said first and second jaws;and an indicator configured to indicate a thickness of said tissuelocated between said first jaw and second jaws at a location which isproximal to said rotation joint.